Cicatricial entropion caused by asymptomatic allergic conjunctivitis

Cicatricial entropion is an acquired process caused by scarring of the inner eyelid with mechanical shortening of the posterior lamella. We present two consecutive patients with cicatricial entropion as the heralding sign of allergic blepharoconjunctivitis. A 12-year-old girl and a 41-year-old man presented to a referral oculoplastics practice with ocular irritation and conjunctival symblepharon. Neither patient had a history of allergic ocular symptoms. Slit lamp examination revealed marked conjunctival scarring of all four eyelids in each patient. Conjunctival scraping and cell staining revealed eosinophils and polymorphonuclear leukocytes. No evidence of infection, including Chlamydia and Herpes zoster, was detected. Asymptomatic allergic blepharoconjunctivitis should be included in the differential diagnosis of cicatricial entropion. Conjunctival scraping may be helpful in the diagnosis.